Splenic Injury Complicating Colorectal Surgery

Iatrogenic splenic injury is a well-recognized and potentially serious complication during different abdominal operations. However, the highest percentage of all iatrogenic splenic injuries is related to colorectal surgery. The most common mechanism is excessive traction on the ligaments attached to the spleen. A less frequent mechanism of injury is a direct mechanical injury of the spleen capsule or parenchyma caused by a surgical instrument. Although the risk factors of splenic injury are a given conditions, splenic injury is a technical error and the surgeon must take all possible measures to avoid it. We will review our strategy and some tips and tricks to avoid splenic injury during colorectal surgery. In addition, we will propose a step-by-step approach to the management of splenic injury during colorectal surgery.